Breast Cancer Awareness Pink Ribbon

(jamie garrison) hi everybody, for those of you who don't know me, my nameis jamie garrison. i graduated from uwm's interpreter trainingprogram in 2002, and after my itp graduation, i continued onto finish up my bachelor's of science in exceptional education, which i graduated in 2004 with my b.s. um.... and i've been pretty much interpreting eversince. i got my foot in the door during my professionalinternship,

and after i graduated with my bachelor's iwas hired, so i started interpreting right away aftergraduation, and have been doing so ever since, primarily in community-based interpreting. and i was diagnosed with breast cancer in2011 at the age of 30. it wasn't all that much of a surprise, because breast cancer runs in my family. but with that being said, whether you havebreast cancer in your family or not,

it's really important to be um... diligent about doing your self-exams, because i was the one who caught my breastcancer, it was not a doctor, was not a mammogram. and so, had i not been diligent about doingthat, who knows if i would have caught it as early as we did. and i just want to stress the point that men can get breast cancer as well. it's not just women.

so men, you should be feeling your boobiesas well [laughing]. it might not be the same as women do, or it may not be found the same as women findit, but usually it's a lump or something likethat, thickened breast tissue or abnormal changesto the nipple area. moving on, i have some symptoms of breastcancer i've listed. i think it's important to just be aware ofthose, so that you know what you're looking for. not all breast cancer's familial,

you know, sometimes it runs in the family and other times it does not. so do the breast exams whether you have itin your family or not. one obvious sign or symptom of breast cancerwould be swelling of all or part of the breast and a change in size. the other would be skin irritation or dimplingor pitting, which is not smooth skin but ends up lookingsort of like the peel of an orange, just a little bit of dimpling to it.

that's something you can look at as well. and you'll notice, as you look at my powerpoint, that there's a little pink breast cancer ribbon um...alongside some of the points on my powerpoint. those are things that apply to me, things that i experienced or when i talk about treatment choices i madefor my own treatment. so if you're thinking to yourself, hmmm, i wonder what jamie's experience waslike?

did she have that, did she experience that? um...all of the ones with the pink ribbonapplied to my situation and my experience. so i did have the dimpling of my skin, which is how i knew right away it was breastcancer, 'cause i was aware of that symptom. and that was one of the things that made mego into the doctor. and actually, i wasn't doing a formal breastexam when i found my lump, i was actually like reaching across my bodyto itch my arm [laughing],

and i just ended up grazing the lump, and then i noticed the dimpling of my skin. and that's sort of how i found it, it was just sort of happenstance, it wasn't that i was looking for it. let's see what we have next. next, i'll go a little bit into the scienceof breast cancer, but i'll try not to bore you. i'll add some comments and make it a littlebit more everyday-language,

so it makes more sense. here you'll see some cells. to the left is a normal cell, and then moving on to your right is a non-invasive cell, which is pretty much contained within thecell wall. and then you have the invasive cell, which starts sort of spilling over the cellwalls. that's not a good thing.

that's when it moves into other tissue, into other normal cells around the body. you don't want it to be invasive. um, and then... next, you'll see the little pink ribbon, which is the invasive ductal carcinoma, that's what i had. that means that you have an invasive cellthat's sort of spilling over the cell walls into other tissue,

and then "ductal," it was in the ducts ofmy breast. "carcinoma" is cancer. so those are just a couple of different typesof breast cancer cells that you might hear or read about or experience. hopefully, you won't yourself, but maybe somebody you know may have had breastcancer. let's see. and then...

i go a little bit into the grade of the breastcancer, they call it a "grade"of cancer. it's a "score." it tells you how different are your cancercells from those normal cells that you have in your body. um, mine was grade 2, so they were moderately different than thenormal cells in my body. and actually, i didn't really understand thiswhen they first gave this score to me, i thought it was, you know they say the "stage,"

what "stage" of cancer do you have. now, as i researched more into it, it makes a little bit more sense. so if you do any interpreting forbreast cancer appointments, you might hear some of these termsbecause a lot of doctors and hospital staff will throw aroundthis grading. or even some patients who have beenthrough breast cancer treatment. next, i moved into the tumor size. that varies greatly from patient to patient.

it can be as small as 1 centimeter,which is the size of a pea. mine was more like 2 centimeters or so,a little bit over 2 centimeters, up to 5 which is the size of a limeand that is pretty darn big. next you hear a lot about surgical margins. patients and staff of the oncology departmenttalk a lot about surgical margins. again, it sort of comes back to thatinvasive cell or non-invasive. does that cell, sort of, contain itselfor does it start spilling over into places that it shouldn't be. and on the left hand is the negativesurgical margins.

so you can see that the cancer cellis sort of within the normal tissue and it's pretty clear around the edgesof the cancer cells. and to the right, which is positive,it's not quite as clear cut. you can see, sort of, the normal tissueand the cancer cells coming together, and it's sort of more zig-zaggededge to it. so that's not necessarily a good thing,you don't want that either. i was very lucky in the fact that ihad clear surgical margins, which means when they go,went out to take the tumor it was pretty clear cut, when theytook the tumor they took everything

because it was contained within itself. and then moving onto the next part... you can see the lymphatic orvascular invasion. on the right you see the human bodyand the lymphatic system. i didn't realize before this that there wereso many lymph nodes within your body. and the lymph nodes act as filters fordifferent toxins or sickness. and when the breast cancer bleeds intothe lymphatic system it's not necessarily a good thing because the lymphaticsystem takes all the healthy lymphatic fluid and moves it around your body tocontinuously filter the toxins

or other things you needto get out of your body. because once your cancer gets intoyour lymph nodes, there's a good chance that it's traveling away from your breastinto other parts of the body. so the more lymph nodes thatare involved the worse it is. i don't know the exact number ofhow many lymph node you have in your body, but i have friends thathad 20-some lymph nodes involved that they found cancer is 20-somelymph nodes. so they, umm, removed all thoselymph nodes from their body. i can't imagine.

i was lucky enough that they only foundcancer in like 2 lymph nodes. that's all they had to remove for me,which is good because you may have heard of other problems like lymphedema whichwhen you have these lymph nodes removed from your body now your toxic fluid in yourbody or all your illness doesn't have anywhere to go because it can't befiltered through these lymph nodes when they are removed. and it ends up backing up inwhatever place, it gets stopped up in the system or the flow of fluid. a lot of women have lymph nodestaken out from their breast or their armpit

because that's the area that is closestto the cancer and that's where it ends up getting stopped up so, you know, if thesick lymphatic fluid is traveling either upward from your legs or your feet,or downward from like your head, then it ends up stopping by the armpit. and so there is a backup in fluid inyour arm, a lot of people have lymphedema of the arm. that's when your arm swells up fromall that lymphatic fluid that doesn't have anywhere to go. that's why, you know, as a breast cancerpatient you want to hold on to as many

of those lymph nodes as possibleand hope that they're free of cancer. the next slide talks a little bit abouta type of breast cancer which is the type that i had. you can see the little pink ribbon. it is called estrogen and progesteronereceptors positive. so its er or pr positive. basically what that means is thatthe estrogen progesterone in my body is what was feeding the cancer cellsto grow and thrive in my body. which means means from here on outi can't have any estrogen or progesterone

in my body, so i'm on medicationcurrently to basically put me in early menopause so i don'thave any hormones left in my body. because, if i had any breast cancer cellsleft anywhere those hormones would just feed those cancer cells and have themcontinue to grow and spread. and then her2 status doesn't apply to me,umm, but... it says its a gene that makes proteins,and those are again receptors on breast cells. and so those receptors help controlhow healthy breast cells grow and divide. and basically when you are, umm,they call it "triple negative" breast cancer so you're not er, estrogen receptorpositive and you're not pr positive

progesterone receptor and you arenot her2 positive that's always a scary thing when you're triple negative becausethen they don't know what is feeding the cancer cells and how the cancercells are dividing and living. so if they don't know how your bodyis feeding those cancer cells then they don't necessarily know howto stop the cancer from spreading. and that's a scary thing. i have a lot of friends whoare triple negative. so they just keep pumping their bodiesfull of crap hoping that something works, whether its hormone blocker or aher2 blocker.

so there are different kinds ofbreast cancer. it's not necessarily just cut and dry thatyou have breast cancer and there is one kind that applies to everybody. next is a little bit about the differentkinds of surgery. on the right, is a radical mastectomywhere they completely remove the breast and all the tissues surrounding and thenusually quite a few lymph nodes. you can see the one all the way on theright has a large scar in the armpit area. and to the left is the surgery that i hadwhich is a lumpectomy and in the blue circular area that's just where they were--removed the tumor itself but they don't

remove any other surrounding breast tissue. they're just going in to removethe tumor and that's it. so i had a lumpectomy where theyremoved the tumor but then they did also remove a couple lymph nodesthat were affected. and i decided not to go with themastectomy i guess for kind of vain reasons. i was just in a point where i wasn't ina good place emotionally to be able to make that decision thinking that i'dbe able to go through my life without breasts. i just wasn't sure i wanted to do that. now, after meeting people and doingsome research, they just do beautiful

reconstruction these days that if i hadto go back and do it again i may have chosen the mastectomy. and here is a picture of megoing into surgery. laughing because one of my brotherswas doing like a tap dance on a hospital floor and they were making me laugh. {laughing} so they had the big curtain pulled betweenthe different rooms and he had his feet stuck under the curtain and all youcould see was his feet and he was doing this little tap dance routine soi was laughing my butt off. and then moving on i talk a littlebit about chemotherapy.

not everybody goes through chemo,but i would say most breast cancer patients do because if there are anylingering cancer cells around that they didn't get with the lumpectomyor mastectomy they want to get to those with chemotherapy and that's somethingthat is systemic and it will go through your whole system and attack anylittle buggers that are hanging out that aren't supposed to be. i tried to capture different approachesto giving me chemotherapy. on the upper left-hand picture youcan see almost like an intravenous line they go in through your veins and theystart out giving me chemo through my veins.

but once you put chemo into your veinsit completely destroys them, you know, basically eats up from like the inside-outso they try to avoid that at all costs. because its basically, you know,chemotherapy is poison. once they start pumping that poisoninto your veins whether its on your hand or the bend of your elbow, anywhereyou can get an iv or have blood drawn, then it starts destroying those veins. and in the middle you can see thewoman with like the fanny pack type thing. sometimes they'll send patients homewith a pump. you may have heard of like diabetespumps to give insulin 24 hours a day,

they do that with cancer patients sothat they can be receiving chemotherapy 24 hours a day. and they'll send you home with somekind of intravenous line whether its an iv or in my case i had a picc line. you can see the picture on the way bottomon the left with a little ribbon. i had a picc line surgically put intomy left arm like the inner bicep area. and that's basically surgically donethat they insert that intravenous line into a major vein or artery. and then that's where i was givenmy chemotherapy.

it was an infusion that i would sitfor, umm, a few hours. and my husband and i used tocall that our date day. so we would go sit in infusion,and we would pack a lunch and just sit and talk because itwould be a few hours each day that there were no interruptions,no children, no phone calls. you know, we really didn't--we didn't talk on the phone, we didn't watch television,we didn't do anything, we would just sit in infusionand eat our picnic lunch and talk. once in a while i would sit onfacebook because at the time

i wasn't working or anything, um,that was sort of my connection to my friends in the outside world. i got, you know, that's my chance toget out of my little cancer bubble. there i am at one of my infusions. and that little white thing is a,like a stuffed animal, but it's a little white blood cell. actually, um, kate block had given thatto a friend of ours, and that friend of ours passed it on to me when sheno longer needed it. so that was like my positive energyto keep building new white blood cells.

that's usually what most cancer patientshave the hardest time is once all those white blood cells are killed off by thechemotherapy, cuz chemo attacks both the healthy cells and the cancer cells. there are lots of negative effects as well. white cells being one of them. after my chemo infusions i usuallyhad to try to keep myself like in the house so i didn't get sick because my immunesystem was completely knocked down. they suggested that i didn't go outin public, that i didn't eat any like raw vegetables

or anything that might have somethingthat could make me sick. so that was my good karma basicallyhelping with, you know, encourage my white blood cells to spike back up. let's see, i'm just trying to seewhat i put on my powerpoint, sorry everybody! [clears throat] here is more shots of my head as ilost my hair through my chemotherapy process. one thing that nobody ever told me that ithought was interesting, umm, is the fact that it actually hurts when you lose yourhair. it almost feels like little pins or little like, not quite as sharp as pins, butlittle like pricks. if you've ever gotten

a haircut and you have little pieces of hairon you and it sort of hurts, that is what it felt like, but in your head so it hurtto put my head on my pillow when i went to sleep at night, and so on the top left, istarted losing my hair almost like a receding hair line. i still had a little bit of stubblein the back and then as you move to the right on the top, i was losing more of that littlestubble and on the bottom, you can see all the shine on my head. i was really bald barebut it got to the point i learned quickly because it hurt, it actually felt better tojust go ahead and bic the hair that was gone...or the hair that was left, which is what i did.that's how part of the way it got so smooth. a lot of it was just falling out from chemotherapy,but i did bic off the rest of it that i still

had because it took away some of that pain. the next slide i give you an image of someradiation views and it just sort of shows how they give a breast cancer patient radiationwithout radiating their whole torso, because you don't want to pick the heart or the lungsor the stomach or any of that kind of stuff. so they just sort of skim the top of the torsowhile hitting the breasts and trying to avoid hitting any other major organs. in radiationthere is a lot of patients that will have mastectomies for the purpose of just avoidinggetting any kind of radiation because that's as nasty as chemo. it can cause cancer, differentkinds of cancers, after the fact. you know, you start with the primary cancer of breastcancer then get radiated, so it could lead

into like leukemia or some other cancer afterthat. which you may be familiar with the journalist and news anchor, robin roberts.she had breast cancer and then had a blood cancer after the fact probably as a result of havingradiation. i know a lot of women who chose a mastectomyjust in hopes of avoiding radiation, so they went ahead with a mastectomy because theydidn't want to have radiation, and i never really thought about that when i made my decisionto go ahead with a lumpectomy, you know, that i really shouldn't be doing radiation in fearof some of the other crap that comes along with it, but now i am at peace with the decisionthat i made. it is sort of what it looks like.

radiation is interesting. i would go fivedays a week and i went for like seven consecutive weeks for a total of 35 radiation treatments.yeah, it's a lot. after that radiation, there might be armpitdiscomfort. depending on how much your armpit gets hit and chest pain, fatigue, heart problems,lowered white blood cell counts, lung problems, skin reactions. i was actually very lucky.i didn't have any skin burns or anything when i had radiation. i actually credit a lot ofmy cancer treatments and that i didn't have a whole lot of side effects to acupuncture.i went faithfully to acupuncture every day through my whole radiation treatment, andthey can focus on all kinds of stuff. when i was in chemo, every time my white bloodcells were really low, i would get medication

to help boost up my white blood cells again,but i would go to acupuncture as well. so, that helped. i tried to balance out the easternand western medicine in hopes that it wasn't quite as rough on my body. then on the next slide it says tamoxifen. that's a medication i was on after all my treatments to block the estrogen and progesteronein my body. that's a very common medication. i would say it is probably the most common,blocking the body from producing those hormones. most women are on that 5 to 10 years afterthe cancer. studies have shown that the first

five years after your cancer treatment areat the highest risk of recurrence, so a lot of the treatments out there will be for atleast five years, if not more. which now i am over that five year mark, soi was on the tamoxifen but with tamoxifen there is a risk of blood clots and i am prone toblood clots anyways, so the doctor was nervous about that and took me off of that and nowi am on something different. so it's like every treatment out there comes with somesort of side effect or negative effect, something that comes along with it. all of these arekind of bad news, you know, they are good news for the fact they get rid of the cancerand keep it away, but they just mess up your body. you know, it's like you need one medicine tocounteract the negative effects of the last

one and it's just this ongoing cycle. umm, most of the information i got was frombreastcancer.org, and then a lot of the images were just like google images that i found. i justwant to make sure that i list the references. i think that's pretty much it for the references.okay. well, thank you for your time everybody. i hope you learned a little bit. i hope youwere able to take away a little nugget of, you know, information or knowledge, awarenessfrom my presentation. i wanted to give you some insight on what the whole,that chapter of my life was like. honestly, i mean, for me it wasn't quite as scary as it probably is for a lotof women, but because i was aware of the symptoms

of breast cancer and i did my self-exams,i was able to catch it early. when i was diagnosed, i was only at stage one, which is very treatable.so, i think that is the thing i want to stress the most is just know your normal. women havebreast changes every month with their cycle. you may have cysts that develop and thosefeel very similar, but if you know your normal, that you know you have a lump on the firstday of the month and by the time your period was over, the last day of the month it justwent away and it didn't come back until the first of the following month, then it is probablyhormonal and most breast cancers, i'm not going to say all, but most breast cancersdon't hurt, so if you have a tender lump it

is more than likely a cyst or something elsebut anytime you feel something that wasn't there the month before and you're not sureabout it, go to a doctor. i think it's scarier to not have it checked out than it is to haveit checked out because who knows if it is cancer, you know, if it spread... and that's the thingi would stress about men. it's probably embarrassing to go to the doctor and say, "hey, i havethis lump on my chest. i don't know what it is" i know it is very embarrassing, it'sprobably a pride thing, but a lot of men have very advanced breast cancer because they put it off for so long going to the doctor. it spread to other parts of the body and usually menend up dying from breast cancer more than

women do because they put it off for so longthat it is no longer curable. you know, talk to the men in your life, talk to thewomen in your life. pass on the information.do a little bit of homework yourself. check out that breastcancer.org. it is very userfriendly. there are lots of other websites and other resources out there. while it isa scary thing, it's very treatable if you catch it early enough and as i went throughsome of my slides, i hope that you see that when it is treatable withchemo or radiation, or surgery that it is really not as scary as you mightthink if you are not familiar with it.

the more knowledge you have, it takesaway some of that mystery behind it. i really think thatawareness and self exams are the two most important things iwould like for you to take away from this. those are the things that will save you orsomebody you love.